Porubcin Stefan, Rovnakova Alena, Zahornacky Ondrej, Jarcuska Pavol
The Department of Infectious Diseases and Travel Medicine, Louis Pasteur University Hospital, Kosice, Slovakia.
Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovakia.
Ultrasound. 2025 Jul 20:1742271X251356613. doi: 10.1177/1742271X251356613.
Acute viral hepatitis A remains a significant public health concern.
This study investigated the relationship between gallbladder wall pathology, liver stiffness measurements, controlled attenuation parameter, and biochemical markers in adult patients with acute viral hepatitis A.
Overall, 42 patients with acute viral hepatitis A were studied over 3 months. Patients underwent ultrasound and transient elastography examinations. Gallbladder wall thickness was categorised into two groups: 3-10 mm (group A) and ⩾10 mm (group B).
Gallbladder wall thickening was detected in 95% of patients. Stratification and fluid accumulation were present in 71% and 38% of patients, respectively. Gallbladder wall thickness ⩾10mm was significantly associated with stratification and fluid accumulation (p < 0.0001). Higher gallbladder wall thickness correlated with elevated alanine aminotransferase (p = 0.008), ammonia levels (p = 0.011), and international normalised ratio (p = 0.047). A positive correlation was observed between procalcitonin levels ⩾0.25 ng/mL and gallbladder wall thickness ⩾10 mm (p = 0.011). The controlled attenuation parameter values were significantly lower in patients with greater gallbladder wall thickness (p = 0.013), while liver stiffness measurement showed no correlation with gallbladder wall thickness.
In acute viral hepatitis A, gallbladder wall thickening is almost a pathognomonic finding. Increased gallbladder wall thickness correlates with increased alanine aminotransferase, ammonia, international normalised ratio, and procalcitonin levels, highlighting its potential as a non-invasive marker of disease severity. Controlled attenuation parameter and liver stiffness measurement require cautious interpretation in acute inflammation. These findings support gallbladder wall assessment as a valuable tool in evaluating acute viral hepatitis A.
急性甲型病毒性肝炎仍是一个重大的公共卫生问题。
本研究调查了成年急性甲型病毒性肝炎患者胆囊壁病理、肝脏硬度测量值、受控衰减参数与生化标志物之间的关系。
总共对42例急性甲型病毒性肝炎患者进行了为期3个月的研究。患者接受了超声和瞬时弹性成像检查。胆囊壁厚度分为两组：3 - 10毫米（A组）和≥10毫米（B组）。
95%的患者检测到胆囊壁增厚。分别有71%和38%的患者存在分层和积液。胆囊壁厚度≥10毫米与分层和积液显著相关（p < 0.0001）。较高的胆囊壁厚度与丙氨酸氨基转移酶升高（p = 0.008）、氨水平（p = 0.011）和国际标准化比值（p = 0.047）相关。降钙素原水平≥0.25 ng/mL与胆囊壁厚度≥10毫米之间存在正相关（p = 0.011）。胆囊壁厚度较大的患者受控衰减参数值显著较低（p = 0.013），而肝脏硬度测量值与胆囊壁厚度无相关性。
在急性甲型病毒性肝炎中，胆囊壁增厚几乎是一个特征性表现。胆囊壁厚度增加与丙氨酸氨基转移酶、氨、国际标准化比值和降钙素原水平升高相关，突出了其作为疾病严重程度非侵入性标志物的潜力。在急性炎症中，受控衰减参数和肝脏硬度测量值的解读需要谨慎。这些发现支持将胆囊壁评估作为评估急性甲型病毒性肝炎的一种有价值的工具。
